Representatives for the Fulton Medical Center have had meetings with local government about obtaining public financing.
"They're looking for help and we're looking to see if we can help," Fulton Mayor LeRoy Benton said. "We're very restricted about how we can help them."
Fulton Medical Center is faced with losses due to patients who can't pay for their health care, Callaway County Presiding Commissioner Gary Jungermann said.
Present at one meeting last week were Jungermann, Fulton Mayor LeRoy Benton, Executive Director of the Callaway Chamber of Commerce Tamara Fitzpatrick, Fulton Director of Administration Bill Johnson, Fulton Medical Center CEO Mike Powell and a NueHealth representative.
"We did meet with them about three months ago," Benton added. "They said things were not looking good, but they were making some positive headway. It is a tough business."
NueHealth LLC, a private, for-profit company, and the University of Missouri Health Care purchased the Fulton Medical Center - then known as the Callaway Community Hospital - in December 2014.
At the time, then-chairman of Nueterra Dan Tasset said, "Nueterra has a strong record of improving access, affordability and quality of care in communities similar to Fulton."
"I think they did have a (business) plan," Benton said, "It's a private firm and they didn't consult us."
Since then, unpaid medical expenses from the indigent have impacted the company's finances, Jungermann said company officials mentioned in meetings.
"They're just worried that they're not ever going to break even," he added. "On an average, they're losing close to $200,000 a month. They're trying to figure out ways to supplement their losses."
By law, emergency rooms are required to treat anyone who walks through the door, regardless of whether or not they can pay.
MU Health has made large contributions to the hospital since its
formation, according to MU spokesperson Mary Jenkins.
"As a non-controlling minority member of the limited liability company, the university has made approximately $1.6 million in capital contributions to help fund Fulton Medical Center since it was formed," she said.
One possibility is to create a "hospital district."
"It's real similar to the ambulance district," Jungermann said. "They're their own separate entity and they collect tax dollars to run."
People living within the district would pay additional property tax. He said the city, county and a newly formed hospital district board would likely work together to determine the amount of tax to levy.
However, it wouldn't happen soon, officials said.
"Nothing's going to happen in 2017," Jungermann said. "The potential of something being on the 2018 ballot is there, but it's not a great potential."
The city and county would have to review the hospital's financial records - which they have yet to see, Jungermann said. Then they'd have to determine what area the hospital district would cover, and whether the property owners within it could actually make a dent in the hospital's losses.
Jungermann pointed out people on the west, south and north sides of the county are likely to head towards hospitals in Columbia, Jefferson City or Mexico instead of Fulton. The district would likely encompass just Fulton and east Fulton, he said.
"When we run the numbers, the county and the city might say there's no way we could run this," Jungermann said.
Then the issue would have to be voted on by county residents, a board formed and a levy determined - which might require yet another vote.
Jungermann said if the hospital district or another solution doesn't pass, the hospital's prognosis might be grim.
"That potential is there (for them to leave)," he said.
Nueterra Capital spokesperson Dolores Kitchin said her company wants to do what's best for the community. NueHealth is the parent company of Nueterra Capital.
"We continue to assess the sustainability of Fulton Medical Center, alongside NueHealth," she said.
Kitchin said one in three rural hospitals is at risk of closing, according to studies.
Jungermann believes having a hospital in the county protects public health and is attractive to large businesses.
"Our whole goal is to keep the doors open," Benton added. "There's over 150 jobs - well-paid positions."
When asked why Fulton Medical Center was seeking public funding, Kitchin said that's not the right question.
"The real question is, 'How can we meet the healthcare needs of our community?'" she said. "One idea on the table is turning to our community to look for the best solution, but no decisions have been made yet, and the discussion is continuing to evolve."
Benton said he wasn't sure what to think.
"I'm still kind of up in the air," he said.
Jungermann also has reservations about potentially using taxpayer dollars to support a hospital which is largely controlled by a for-profit company. (NueHealth has a 65 percent stake in the hospital, he said.)
"But when you look at it from the public safety avenue, that's a whole 'nother question now," Jungermann said. "You're not trying to make a company profitable, you're trying to make sure the needs for public safety are met."
He and other officials are still seeking counsel and advice from experts on the matter, along with community feedback, he said.
"The hospital says they're in trouble, so the question is, how much does the hospital mean to you?" Jungermann said.
Fulton Medical Center background
In April 2015, hospital officials announced the name of Callaway Community Hospital would be changed to Fulton Medical Center.
The hospital had been purchased the previous December by Nueterra (now NueHealth) and MU Health Care.
A press release was issued on April 7, 2015 stating:
"We, along with MU Health Care, purchased this hospital knowing a different delivery model was the only way the hospital would survive," said Dan Tasset, chairman of Nueterra. "We're providing up to $2 million in new capital to refurbish the existing hospital facility and site. With so many improvements taking place, we decided to rename the hospital to officially signal a new beginning for the community."
Hospital officials promised to fix a leaking room, renovate the clinical areas and exterior, and install new equipment to improve
"MU Health Care is looking forward to modernizing Fulton Medical Center and providing quality, affordable healthcare - which will advance the health of our community and the state of Missouri," said Mitch Wasden, chief executive officer and chief operating officer of MU Health Care.
University of Missouri (MU) Health Care and Nueterra formed Fulton Medical Center LLC to purchase Fulton Medical Center, according to a Dec. 4, 2014, news release. University of Missouri Health Care would participate as a minority owner in the joint venture to own and operate Callaway Community Hospital. Nueterra, a global health care management company based in Leawood, Kansas, would be the majority owner of the hospital.
And, according to that press release, MU faculty and resident physicians were seeing more than 15,000 outpatients each year in Callaway County. And, since 1974, approximately 400 family medicine resident physicians had trained at the Callaway County outpatient clinic and hospital.
Included in the December 2014 press release, Tasset included the following statement: "Nueterra has a strong record of improving access, affordability and quality of care in communities similar to Fulton. Through this partnership with MU Health Care, we are committed to being a part of this community and empowering physicians and health care providers to offer the highest quality of care possible."